Organization
PROMEDICA CENTRAL PHYSICIANS,LLC
Active
Other names
Oak Valley Primary Care Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY GOVAN (CREDENTIALING COORDINATOR)
(419) 824-7221
Entity
Organization
Contact information
Practice address
22 TURTLE CREEK CIR, SUITE E, SWANTON, OH 43558-8591
(419) 825-2387
(419) 825-3783
Mailing address
22 TURTLE CREEK CIR, SUITE E, SWANTON, OH 43558-8591
(419) 825-2387
(419) 825-3783
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
35086025
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4036950014
DMERC
OH
01
—
PENDING
MMOH
OH
Enumeration date
08/15/2007
Last updated
11/29/2007
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